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"LONG COVID"-A hypothesis for understanding the biological basis and pharmacological treatment strategy.

Pharmacology research & perspectives
February 1, 2022
Bevyn Jarrott et al. (5 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate melatonin as a potential treatment for LONG COVID symptoms, particularly insomnia, depression, fatigue, and "brain fog," by assessing its ability to activate NRF2 and reduce oxidative stress.

Results Summary

The study hypothesizes that melatonin, as an NRF2 activator, may alleviate oxidative stress in LONG COVID patients, but no clinical trial results are reported to confirm efficacy.

Population

LONG COVID patients experiencing symptoms like insomnia, depression, fatigue, and "brain fog" but not tachycardia.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
melatonin
increase
expression of enzymes to synthesize the intracellular antioxidant, glutathione
-
-
may increase the expression of enzymes to synthesize the intracellular antioxidant, glutathione
#1
melatonin
decrease
free radicals causing oxidative stress
-
-
will quench free radicals
#2
melatonin
decrease
symptoms (insomnia, depression, fatigue, and "brain fog")
"LONG COVID" subjects experiencing insomnia, depression, fatigue, and "brain fog" but not tachycardia
-
is an option for consideration of re-purposing studies
#3
Abstract

Infection of humans with SARS-CoV-2 virus causes a disease known colloquially as "COVID-19" with symptoms ranging from asymptomatic to severe pneumonia. Initial pathology is due to the virus binding to the ACE-2 protein on endothelial cells lining blood vessels and entering these cells in order to replicate. Viral replication causes oxidative stress due to elevated levels of reactive oxygen species. Many (~60%) of the infected people appear to have eliminated the virus from their body after 28 days and resume normal activity. However, a significant proportion (~40%) experience a variety of symptoms (loss of smell and/or taste, fatigue, cough, aching pain, "brain fog," insomnia, shortness of breath, and tachycardia) after 12 weeks and are diagnosed with a syndrome named "LONG COVID." Longitudinal clinical studies in a group of subjects who were infected with SARS-CoV-2 have been compared to a non-infected matched group of subjects. A cohort of infected subjects can be identified by a battery of cytokine markers to have persistent, low level grade of inflammation and often self-report two or more troubling symptoms. There is no drug that will relieve their symptoms effectively. It is hypothesized that drugs that activate the intracellular transcription factor, nuclear factor erythroid-derived 2-like 2 (NRF2) may increase the expression of enzymes to synthesize the intracellular antioxidant, glutathione that will quench free radicals causing oxidative stress. The hormone melatonin has been identified as an activator of NRF2 and a relatively safe chemical for most people to ingest chronically. Thus, it is an option for consideration of re-purposing studies in "LONG COVID" subjects experiencing insomnia, depression, fatigue, and "brain fog" but not tachycardia. Appropriately designed clinical trials are required to evaluate melatonin.

Medical Subject Headings (MeSH)
Antiviral AgentsBiomarkersCOVID-19Endothelium, VascularHumansSARS-CoV-2Virus ReplicationPost-Acute COVID-19 SyndromeCOVID-19 Drug Treatment
Study Links
Quality Scores
Safety80
Efficacy60/10
Quality70/10
Citation Metrics
Total Citations77
Citations/Year25.7
Relative Citation Ratio9.18
NIH Percentile97.5%
Research Impact Scores
APT Score0.95
Weight Score1.41
Normalized Score0.70
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"LONG COVID"-A hypothesis for understanding the biological b... | Panacea Index